Prognostic utility of semi-quantitative coronary computed tomography angiography scores in the SCOT-HEART trial.
Maclean E., Cronshaw R., Newby DE., Nicol E., Williams MC.
BACKGROUND: Information from cardiac computed tomography angiography can be summarized using visual semi-quantitative scores. However, the optimal method and their prognostic utility is unknown. METHODS: Five semi-quantitative scores were calculated in the SCOT-HEART trial, including segment involvement score (SIS), segment stenosis score (SSS), CT Leaman (CT-LeSc), multivessel aggregate stenosis score (MVAS), and CAD-RADS 2.0 including plaque modifier (P). Prediction of fatal or non-fatal myocardial infarction and major adverse cardiovascular events (MACE) was compared to the 10-year cardiovascular risk score. RESULTS: Imaging was performed in 1,769 individuals (age 58 ± 10 years, 56% male) with 41 (2.3%) experiencing myocardial infarction and 74 (4%) MACE over 4.9 ± 1.1 years. P based on calcium score and SIS had good agreement (weighted Cohen's kappa 0.79, 95% confidence interval [CI] 0.79, 0.79). SIS, SSS, CT-LeSec, and MVAS performed similarly for the prediction of myocardial infarction (area under the curve [AUC] 0.74, 0.75, 0.75, 0.74, all p > 0.1) and MACE (AUC 0.73, 0.74, 0.74, 0.73, all p > 0.1), and were superior to the cardiovascular risk score (AUC 0.62 and 0.65, both p